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Mar 2014

The Cause of Menopause

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So a lot of women begin noticing a host of physical and emotional changes around age 50. At some point most of these women hopefully understand that they are not losing their minds, but they are in fact going through. Menopause is a natural transitional period for women, the FDA does not consider menopause a disease and rightfully so. While all women do not have symptoms of menopause, all women go through menopause. The more common symptoms of menopause are not generally considered dangerous, but they are uncomfortable. The purpose of this article is to understand, biologically, what is going on inside a woman’s body when menopause occurs. First here is some background.

The word “menopaus [1]” comes from the Greek words men (month) pausis[2] (stop or end). The term refers to end of the menstrual or “monthly” cycle in women. Menopause is formally said to begin at the end of the last menstrual cycle. The average age of menopause is 51 in Western countries. The main factors that determine the end of menstrual cycle and the onset of menopause are the health of a woman’s ovarian tissue and the availability of functioning eggs. The availability of functioning eggs and the state of the ovarian tissue naturally decline due to age. The ovaries play a major role in a woman’s estrogen levels so when they stop their primary functions, estrogen levels drop causing the various physical and psychological symptoms connected to menopause. To really understand menopause it is necessary to learn more about the connection between the ovaries and estrogen.

Inside the ovaries are hollow balls of cells called follicles which are responsible for estrogen production. Each follicle houses an immature egg (oocyte) in the center. During menstruation a hormone called follicle stimulating hormone (FSH) signals the follicles to begin maturing. As these follicles mature they release estrogen into the body to prepare the uterus for pregnancy. After about a week, all but one follicle stop maturing. The maturing follicle releases a surge of estrogen which causes the brain to release luteinizing hormone which causes the follicle to grow rapidly until it releases the egg into the fallopian tube and eventually the egg reaches the uterus ready to be inseminated.

As women age they lose eggs and ovarian follicles that were responsible for estrogen production. Although estrogen continues to be produced in other tissues, notably in bone, blood vessels and even in the brain. The decrease in the production of estrogen is responsible for menopausal symptoms. The most common of which is the hot flash. The second most common symptom is the night sweat which is essentially an intense hot flash that occurs during your sleep. Anyway, scientists are not sure why, but the loss of estrogen causes the perception of increased heat in the body which causes a rush of blood to the surface of your skin so that it can be cooled off by the outside temperatures. This initial rush of blood is a hot flash.

The theory I described above is assuming the “hour glass” way of looking at menopause. The analogy relates a woman’s eggs to an hour glass filled with sand, once it is turned over, the sand starts slowly dumping to the bottom until there is nothing left. But, this may not be the way menopause actually works. Scientist’s took the tissue from the ovary of mice that were going through menopause and attached them to the tissue of young and wild mice. Something amazing then happened. The cells from the mouse with the menopausal ovary started to produce eggs again. This is great news for older women, because they do not run out of eggs, but rather their eggs go into a period of inactivity. Theoretically this works in humans too! So if a woman with a menopausal ovary is exposed to tissue of a young-adult ovary, the menopausal ovary will, almost magically, start producing eggs again.

So now we know that menopause is not caused by simply running out of eggs. Menopause is a biological condition that stems from the inactivity of the ovaries in particular the follicles that are responsible for so much of a woman’s estrogen production. When the estrogen is not being regularly produced as the body was used to for the previous 40 or so years, woman start experiencing symptoms.

[1] Menopause (n.)
1852 (from 1845 as a French word in English), from French ménopause, from medical Latin menopausis, from Greek men (genitive menos) “month” (see moon (n.)) + pausis “a cessation, a pause,” from pauein “to cause to cease” (see pause (n.)). Earlier it was change of life. (
[2] Derived from the Greek word pauein, παύειν (to stop (transitively or intransitively); restrain, quit, desist, come to an end)

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